1. Definitions of Maltreatment
1. Centers for Disease Control and Prevention (2014). Understanding child maltreatment.
Retrieved from http://www.cdc.gov/violenceprevention/pdf/understanding-cm-
factsheet.pdf
“Physical abuse is the use of intentional physical force, such as hitting, kicking, shaking, burning, or
other show of force against a child.”
2. Merrick, M., & Latzman, N. (2014). Child maltreatment: a public health overview and
prevention considerations. The Online Journal of Issues in Nursing, 19 (1). DOI:
10.3912/OJIN.Vol19No01Man02
“Physical abuse: intentional use of physical force against a child that results in, or has the potential to
result in, physical injury. Exceptions: physical injuries to the anal or genital area or surrounding areas (
e.g. anal or genital bruising or tearing; internal injuries resulting from penetration by a penis, hand,
finger, or other object) that occur during attempted or completed sexual abuse (SA), or other physical
injuries that result from attempted or completed SA ( e.g., bruises due to restraint, hitting, pushing) are
considered SA and do not constitute as physical abuse.”
“Neglect: the failure to provide for a child’s basic physical, emotional, or educational needs or to
protect a child from harm or potential harm.”
“Failure to provide: failure by a caregiver to meet a child’s basic physical, emotional, medical/dental,
or educational needs, or combination thereof.”
“Failure to supervise: failure by the caregiver to ensure a child’s safety within and outside the home
given the child’s emotional and developmental needs.”
3. Fakunmoju, S. (2013). Substantiation assessment criteria: a framework for evaluating and
contested substantiation in child protection practice. Child Welfare, 92 (1), 89-114.
“The Court of Appeals reasons that, because maltreatment regulations tend to categorize most acts as
intentional, such implicit categorization may have contributed to incorrect application of the law (i.e.,
the argument that the perpetrator should have foreseen the harm) to the facts of the case (Taylor, 2004).
The court further reasoned that, ‘in respect to intent, it is material whether there was ‘intent’ to injure ‘a
child,’ and concluded that the correct stand of law applicable to the case was unrelated to intent to
injure, but whether appellant’s actions were ‘reckless’ (Taylor, 2004, p. 21, emphasis added)” (98).
“Accidental/unintentional occurrence: instances in which injury is accidental and does not result
from a reckless act; unintentional conduct of poor judgement is misconstrued as acts of maltreatment;
events interpreted as maltreatment are unpredictable occurrence that could neither be prevented nor
reasonably foreseen” (104).

2. “Validation criteria are conceptually driven, whereas invalidation criteria are empirically based; both
types of criteria suggest that evidence and harm are vital to legal outcomes in contested substantiation”
(110).
4. Children's Bureau. (2013). What is child abuse and neglect? recognizing signs and
symptoms. Child Welfare Information Gateway. Retrieved from
https://www.childwelfare.gov/pubs/factsheets/whatiscan/cfm
"The Federal Child Abuse Prevention and Treatment Act (CAPTA), (42 U.S.C.A. § 5106g), as
amended and reauthorized by the CAPTA Reauthorization Act of 2010, defines child abuse and
neglect a, at minimum: 'any recent act or failure to act on the part of a parent or caretaker which results
in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act
which represents an imminent risk of serious harm.' Most Federal and State child protection laws
primarily refer to cases of harm to a child caused by parents or other caregivers; they generally do not
include harm caused by other people such as acquaintances or strangers. Some State laws also include a
child's witnessing of domestic violence as a form of abuse or neglect."
"many States identify abandonment and parental substance abuse as abuse and neglect."
"Physical abuse is non-accidental physical injury (ranging from minor bruises to severe fractures or
death) as a result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting
(with a hand, stick, strap, or other object), burning, or otherwise harming a child, that is inflicted by a
parent, caregiver, or other person who has responsibility for the child. Such injury is considered abuse
regardless of whether the caregiver intended to hurt the child. Physical discipline, such as spanking or
paddling, is not considered abuse as long as it is reasonable and causes no bodily injury to the child."
"Neglect is the failure of a parent, guardian, or other caregiver to provide for a child's basic needs.
Neglect may be: physical (failure to provide necessary food or shelter, or lack of appropriate
supervision); medical (failure to provide necessary medical or mental health treatment); educational
(failure to educate a child or attend to special education needs), emotional (inattention to child's
emotional needs, failure to provide psychological care, or permitting the child to use alcohol or other
drugs)."
"Some cultural values, the standards of care in the community, and poverty may contribute to
maltreatment, indicating the family is in need of information or assistance. When a family fails to use
information and resources, and the child's health or safety is at risk, then child welfare intervention may
be required. In addition, many States provide an exception to the definition of neglect for parents who
choose not to seek medical care for their children due to religious beliefs."
"Sexual abuse includes activities by a parent or caregiver such as fondling a child's genitals,
penetration, incest, rape, sodomy, indecent exposure, and exploitation through prostitution or the
production of pornographic materials. Sexual abuse is defined by CAPTA as 'the employment, use,
persuasion, inducement, enticement, or coercion of any child to engage in, or assists in any other
person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose or
producing a visual depiction of such conduct; or the rape, and in the cases of caretaker or inter-familial
relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children,
or incest with children.'"
"Emotional abuse (or psychological abuse) is a pattern of behavior that impairs a child's emotional
development or sense of self-worth. This may include constant criticism, threats, or rejection, as well as
withholding love, support, or guidance. Emotional abuse is often difficult to prove, and therefore, child
protective services may not be able to intervene without evidence of harm or mental injury to the child.
Emotional abuse is almost always present when other types of maltreatment are identified."

3. "Abandonment is now defined in many States as a form of neglect. In general, a child is considered to
be abandoned when the parent's identity or whereabouts are unknown, the child has been left alone in
circumstances where the child suffered serious harm, or the parent has failed to maintain contact with
the child or provide reasonable support for a specified period of time. Some States have enacted laws--
often called safe haven laws--that provide safe places for parents to relinquish newborn infants."
"Substance abuse is an element of the definition of child abuse or neglect in many States.
Circumstances that are considered abuse or neglect in some States include the following: prenatal
exposure of a child to harm due to the mother's use of an illegal drug or other substance; manufacture
of methamphetamine in the presence of a child; selling, distributing, or giving illegal drugs or alcohol to
a child; use of a controlled substance by a caregiver that impairs the caregiver's ability to adequately
care for the child."
5. American Humane Association. (2007). Chronic child neglect: understanding the
definition and impact of neglect. Retrieved from:
http://www.americanhumane.org/children/stop-child-abuse/fact-sheets/child-
neglect.html
"[In 2005,] 62.8% of children in the US suffered from neglect, 16.6% physical abuse, 9.3 sexual abuse,
7.1% emotional/psychological abuse, 2% medical neglect, 14.3% other."
"[The National Child Abuse and Neglect Data System (NCANDS)] defines neglect as “a type of
maltreatment that refers to the failure by the caregiver to provide needed, age-appropriate care although
financially able to do so or offered financial or other means to do so” (USDHHS, 2007). Neglect is
usually typified by an ongoing pattern of inadequate care and is readily observed by individuals in close
contact with the child."
“Physical neglect accounts for the majority of cases of maltreatment. Physical neglect generally
involves the parent or caregiver not providing the child with basic necessities (e.g., adequate food,
clothing and shelter). Failure or refusal to provide these necessities endangers the child’s physical
health, well-being, psychological growth and development. Physical neglect also includes child
abandonment, inadequate supervision, rejection of a child leading to expulsion from the home and
failure to adequately provide for the child’s safety and physical and emotional needs. Physical neglect
can severely impact a child’s development by causing failure to thrive; malnutrition; serious illness;
physical harm in the form of cuts, bruises, burns or other injuries due to the lack of supervision; and a
lifetime of low self-esteem.
Educational neglect involves the failure of a parent or caregiver to enroll a child of mandatory school
age in school or provide appropriate home schooling or needed special educational training, thus
allowing the child or youth to engage in chronic truancy. Educational neglect can lead to the child
failing to acquire basic life skills, dropping out of school or continually displaying disruptive behavior.
Educational neglect can pose a serious threat to the child’s emotional well-being, physical health or
normal psychological growth and development, particularly when the child has special educational
needs that are not met.
Emotional/Psychological neglect includes actions such as engaging in chronic or extreme spousal
abuse in the child’s presence, allowing a child to use drugs or alcohol, refusing or failing to provide
needed psychological care, constantly belittling the child and withholding affection. Parental behaviors
considered to be emotional child maltreatment include:
 Ignoring (consistent failure to respond to the child’s need for stimulation, nurturance,
encouragement and protection or failure to acknowledge the child’s presence);
 Rejecting (actively refusing to respond to the child’s needs — e.g., refusing to show affection);
 Verbally assaulting (constant belittling, name calling or threatening);

4.  Isolating (preventing the child from having normal social contacts with other children and
adults);
 Terrorizing (threatening the child with extreme punishment or creating a climate of terror by
playing on childhood fears); and
 Corrupting or exploiting (encouraging the child to engage in destructive, illegal or antisocial
behavior).
A pattern of this parental behavior can lead to the child’s poor self-image, alcohol or drug abuse,
destructive behavior and even suicide. Severe neglect of an infant’s need for stimulation and nurturance
can result in the infant failing to thrive and even infant death. Emotional neglect is often the most
difficult situation to substantiate in a legal context and is often reported secondary to other abuse or
neglect concerns.
Medical neglect is the failure to provide appropriate health care for a child (although financially able to
do so), thus placing the child at risk of being seriously disabled or disfigured or dying. According to
NCANDS, in 2005, 2 percent of children (17,637 children) in the United States were victims of medical
neglect (USDHHS, 2007). Concern is warranted not only when a parent refuses medical care for a child
in an emergency or for an acute illness, but also when a parent ignores medical recommendations for a
child with a treatable chronic disease or disability, resulting in frequent hospitalizations or significant
deterioration. Even in non-emergency situations, medical neglect can result in poor overall health and
compounded medical problems.
Parents may refuse medical care for their children for different reasons religious beliefs, fear or anxiety
about a medical condition or treatment, or financial issues. Child protective services agencies generally
will intervene when:
Medical treatment is needed in an acute emergency (e.g., a child needs a blood transfusion to treat
shock);
 A child with a life-threatening chronic disease is not receiving needed medical treatment (e.g., a
child with diabetes is not receiving medication); or
 A child has a chronic disease that can cause disability or disfigurement if left untreated (e.g., a
child with congenital cataracts needs surgery to prevent blindness).
In these cases, child protection services agencies may seek a court order for medical treatment to save
the child’s life or prevent life-threatening injury, disability or disfigurement. Although medical neglect is
highly correlated with poverty, there is a distinction between a caregiver’s inability to provide the
needed care based on cultural norms or the lack of financial resources and a caregiver’s knowing
reluctance or refusal to provide care. Children and their families may be in need of services even though
the parent may not be intentionally neglectful. When poverty limits a parent’s resources to adequately
provide necessities for the child, services may be offered to help families provide for their children."
6. Hibbard, R., Barlow, J., MacMillan, H. (2012). Clinical report: psychological
maltreatment. Pediatrics 13(92):372-378. doi:10.1542/peds.2012-2269
"Caregiver behaviors include acts of omission (ignoring need for social interactions) or commission
(spurning, terrorizing); may be verbal or nonverbal, active or passive, and with or without intent to
harm; and negatively affect the child's cognitive, social, emotional, and/or physical developmental
trajectory"
"Psychological maltreatment encompasses both the cognitive and affective components of
maltreatment. One of the difficulties in clearly defining what such maltreatment comprises involves the
absence of a strong societal consensus on the distinction between psychological maltreatment and
suboptimal parenting. Exposure to psychological maltreatment is considered when acts of omission or

5. commission inflict harm on the child's well-being, which may then be manifested as emotional distress
or maladaptive behavior in the child. Psychological maltreatment is difficult to identify, in part because
such maltreatment involves a 'relationship between the parent and the child rather than an event or
series of repeated events occurring within the parent-child relationship.' Isolated incidents of
behavior...do not necessarily constitute psychological abuse. Psychological maltreatment refers to a
repeated pattern of parental behavior that is likely to be interpreted by a child that he/she is unloved,
unwanted, or serves only instrumental purposes and/or that severely undermines the child's
development and socialization. Recent conceptualization of psychological maltreatment focuses on the
caregiver's behaviors as opposed to the disturbed behaviors in the child."
"It is more often associated with multiple family stresses, and in particular, with factors such as family
conflict, adult mental health problems, and parental substance abuse that may be co-occurring. For
example, some parental mental health problems are associated with unpredictable and frightening
behaviors, and others (particularly depression) are linked with parental withdrawal and neglect.
Similarly, in terms of family conflict, attacks on a parent almost always frighten a child, even if the
child is not the direct target. Threats or actual violence as part of a pattern of aggression against on
parent will sometimes exploit the other parent's or child's fears. Children exposed to violence in the
home are at disproportionate risk of injury, eating disorders, and self-harm, even when they are not
themselves victims of physical violence.”

6. 7. World Health Organization (2006). Chapter 3: child abuse and neglect by parents and
other caregivers. World Report on Violence and Health. 59-81
“The International Society for the Prevention of Child Abuse and Neglect recently compared
definitions of abuse from 58 countries and found some commonality in what was considered abusive
(7). In 1999, the WHO Consultation on Child Abuse Prevention drafted the following definition (8):
‘Child abuse or maltreatment constitutes all forms of physical and/or emotional ill-treatment, sexual
abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or
potential harm to the child’s health, survival, development or dignity in the context of a relationship of
responsibility, trust or power.’ Some definitions focus on the behaviors or actions of adults while others
consider abuse to take place if there is harm or the threat of harm to the child (8–13). The distinction
between behavior–regardless of the outcome – and impact or harm is a potentially confusing one if
parental intent forms part of the definition. Some experts consider as abused those children who have
been inadvertently harmed through the actions of a parent, while others require that harm to the child
be intended for the act to be defined as abusive. Some of the literature on child abuse explicitly includes
violence against children in institutional or school settings (14–17). Physical abuse of a child is defined
as those acts of commission by a caregiver that cause actual physical harm or have the potential for
harm. Sexual abuse is defined as those acts where a caregiver uses a child for sexual gratification.
Emotional abuse includes the failure of a caregiver to provide an appropriate and supportive
environment, and includes acts that have an adverse effect on the emotional health and development of
a child. Such acts include restricting a child’s movements, denigration, ridicule, threats and
intimidation, discrimination, rejection and other nonphysical forms of hostile treatment. Neglect refers
to the failure of a parent to provide for the development of the child – where the parent is in a position
to do so – in one or more of the following areas: health, education, emotional development, nutrition,
shelter and safe living conditions. Neglect is thus distinguished from circumstances of poverty in that
neglect can occur only in cases where reasonable resources are available to the family or caregiver.”
“ Manifestations of child abuse and neglect: Injuries inflicted by a caregiver on a child can take many
forms. Serious damage or death in abused children is most often the consequence of a head injury or
injury to the internal organs. Head trauma as a result of abuse is the most common cause of death in
young children, with children in the first 2 years of life being the most vulnerable. Because force applied
to the body passes through the skin, patterns of injury to the skin can provide clear signs of abuse. The
skeletal manifestations of abuse include multiple fractures at different stages of healing, fractures of
bones that are very rarely broken under normal circumstances, and characteristic fractures of the ribs
and long bones.
The shaken infant: Shaking is a prevalent form of abuse seen in very young children. The majority of
shaken children are less than 9 months old. Most perpetrators of such abuse are male, though this may
be more a reflection of the fact that men, being on average stronger than women, tend to apply greater
force, rather than that they are more prone than women to shake children. Intracranial hemorrhages,
retinal hemorrhages and small ‘‘chip’’ fractures at the major joints of the child’s extremities can result
from very rapid shaking of an infant. They can also follow from a combination of shaking and the head
hitting a surface. There is evidence that about one-third of severely shaken infants die and that the
majority of the survivors suffer long-term consequences such as mental retardation, cerebral palsy or
blindness.
The battered child: One of the syndromes of child abuse is the ‘‘battered child’’. This term is generally
applied to children showing repeated and devastating injury to the skin, skeletal system or nervous
system. It includes children with multiple fractures of different ages, head trauma and severe visceral
trauma, with evidence of repeated infliction. Fortunately, though the cases are tragic, this pattern is
rare.

7. Sexual abuse: Children may be brought to professional attention because of physical or behavioral
concerns that, on further investigation, turn out to result from sexual abuse. It is not uncommon for
children who have been sexually abused to exhibit symptoms of infection, genital injury, abdominal
pain, constipation, chronic or recurrent urinary tract infections or behavioral problems. To be able to
detect child sexual abuse requires a high index of suspicion and familiarity with the verbal, behavioral
and physical indicators of abuse. Many children will disclose abuse to caregivers or others
spontaneously, though there may also be indirect physical or behavioral signs.
Neglect: There exist many manifestations of child neglect, including non-compliance with health care
recommendations, failure to seek appropriate health care, deprivation of food resulting in hunger, and
the failure of a child physically to thrive. Other causes for concern include the exposure of children to
drugs and inadequate protection from environmental dangers. In addition, abandonment, inadequate
supervision, poor hygiene and being deprived of an education have all been considered as evidence of
neglect.”
“Corporal punishment of children --- in the form of hitting, punching, kicking or beating --- is socially
and legally accepted in most countries. In many, it is a significant phenomenon in schools and other
institutions and in penal systems for young offenders. The United Nations Convention on the Rights of
the Child requires states to protect children from ‘‘all forms of physical or mental violence’’ while they
are in the care of parents and others, and the United Nations Committee on the Rights of the Child has
underlined that corporal punishment is incompatible with the Convention.
In 1979, Sweden became the first country to prohibit all forms of corporal punishment of children.
Since then, at least 10 further states have banned it. Judgements from constitutional or supreme courts
condemning corporal punishment in schools and penal systems have also been handed down ---
including in Namibia, South Africa and Zimbabwe --- and, in 2000, Israel’s supreme court declared all
corporal punishment unlawful. Ethiopia’s 1994 constitution asserts the right of children to be free of
corporal punishment in schools and institutions of care. Corporal punishment in schools has also been
banned in New Zealand, the Republic of Korea, Thailand and Uganda.
Nevertheless, surveys indicate that corporal punishment remains legal in at least 60 countries for
juvenile offenders, and in at least 65 countries in schools and other institutions. Corporal punishment of
children is legally acceptable in the home in all but 11 countries. Where the practice has not been
persistently confronted by legal reform and public education, the few existing prevalence studies suggest
that it remains extremely common.”

9. 8. Slep, A.S., Heyman, R.E., & Foran, H.M. (2015). Child maltreatment in DSM-5 and ICD-
11. Family Process, 54(1) , 17-31. DOI: 10.1111/famp.12131
9. Centers for Disease Control and Prevention (2016). Child abuse and neglect: definitions.
Retrieved from
http://www.cdc.gov/violenceprevention/childmaltreatment/definitions.html
10. Children’s Bureau. (2014). States Statutes: definitions of child abuse and neglect. Child
Welfare Information Gateway. Retrieved from:
https://www.childwelfare.gov/pubPDFs/define.pdf
For the State of Oklahoma
Physical Abuse
Citation: Ann. Stat. Tit. 10A, § 1-1-105
‘Abuse’ means harm, threatened harm, or failure to protect from harm or threatened harm, to the
health, safety, or welfare of a child by a person responsible for the child’s health, safety, or welfare,
including, but not limited to, non-accidental physical or mental injury, sexual abuse, or sexual
exploitation.
‘Harm or threatened harm to the health or safety of a child’ means any real or threatened physical,
mental, or emotional injury or damage to the body or mind that is not accidental, including, but not
limited to, sexual abuse, sexual exploitation, neglect, or dependency.
‘Heinous and shocking abuse’ includes, but is not limited to, aggravated physical abuse that results in
serious bodily, mental, or emotional injury. ‘Serious bodily injury’ means injury that involves:
 A substantial risk of death
 Extreme physical pain
 Protracted disfigurement
 A loss or impairment of the function of a body member, organ, or mental faculty
 An injury to an internal or external organ or the body

10.  A bone fracture
 Sexual abuse or sexual exploitation
 Chronic abuse, including, but not limited to, physical, emotional, or sexual abuse, or sexual
exploitation that is repeated or continuing
 Torture, including, but not limited to, inflicting, participating in, or assisting in inflicting intense
physical or emotional pain upon a child repeatedly over a period of time for the purpose of
coercing or terrorizing a child for the purpose of satisfying the craven, cruel, or prurient desires
of the perpetrator or another person
 Any other similar aggravated circumstance
Neglect
Citation: Ann. Stat. Tit. 10A, § 1-1-105
‘Neglect’ means any of the following:
Abandonment
The failure or omission to provide any of the following:
 Adequate nurturance and affection, food, clothing, shelter, sanitation, hygiene, or
appropriate education
 Medical, dental, or behavioral health care
 Supervision or appropriate caregivers
 Special care made necessary by the physical or mental condition of the child

The failure or omission to protect a child from exposure to any of the following:
 The use, possession, sale, or manufacture of illegal drugs
 Illegal activities
 Sexual acts or materials that are not age-appropriate
 ‘Heinous and shocking neglect’ includes, but is not limited to:
 Chronic neglect, including a persistent pattern of family functioning, in which the caregiver
has not met or sustained the basic
 needs of a child that results in harm to the child
 Neglect that has resulted in a diagnosis for the child of failure to thrive
 An act or failure to act by a parent that results in the death or near death of a child or
sibling, or serious physical or emotional
 harm, sexual abuse or sexual exploitation, or presents an imminent risk of serious harm to a
child
 Any other similar aggravating circumstance

‘Drug-endangered child’ means a child who is at risk of suffering physical, psychological, or sexual
harm as a result of the use, possession, distribution, manufacture, or cultivation of controlled
substances, or the attempt of any of these acts, by a person responsible for the health, safety, or welfare
of the child. This term includes circumstances in which the substance abuse of the person responsible
for the health, safety, or welfare of the child interferes with that person’s ability to parent and provide a
safe and nurturing environment for the child. The term also includes newborns who test positive for a
controlled dangerous substance, with the exception of those substances administered under the care of a
physician.
Sexual Abuse/Exploitation
Citation: Ann. Stat. Tit. 10A, § 1-1-105
‘Harm or threatened harm to a child’s health or safety’ includes, but is not limited to, sexual abuse or
sexual exploitation. ‘Sexual abuse’ includes, but is not limited to, rape, incest, and lewd or indecent acts

11. or proposals made to a child, as defined by law, by a person responsible for the child’s health, safety, or
welfare.
‘Sexual exploitation’ includes, but is not limited to:
 Allowing, permitting, or encouraging a child to engage in prostitution, as defined by law, by a
person responsible for the child’s health, safety, or welfare
 Allowing, permitting, encouraging, or engaging in the lewd, obscene, or pornographic
photographing, filming, or depicting of a child in those acts by a person responsible for the
child’s health, safety, or welfare

Emotional Abuse
Citation: Ann. Stat. Tit. 10A, § 1-1-105
‘Harm or threatened harm to a child’s health or safety’ includes, but is not limited to, mental injury.
Abandonment
Citation: Ann. Stat. Tit. 10A, § 1-1-105
‘Abandonment’ means:
 The willful intent by words, actions, or omissions not to return for a child
 The failure to maintain a significant parental relationship with a child through visitation or
communication in which incidental or token visits or communication are not considered
significant
 The failure to respond to notice of deprived proceedings
Standards for Reporting Citation: Ann. Stat. Tit. 10A, § 1-2-101
A report is required when any person has reason to believe that a child is a victim of abuse or neglect.
Persons Responsible for the Child Citation: Ann. Stat. Tit. 10A, § 1-1-105
‘Person responsible for a child’s health, safety, or welfare’ includes:
A parent, legal guardian, custodian, or foster parent
A person age 18 or older with whom the child’s parent cohabits or any other adult residing in
the home of the child
An agent or employee of a public or private residential home, institution, facility, or day
treatment program or an owner, operator, or employee of a child care facility
Exceptions Citation: Ann. Stat. Tit. 10A, § 1-1-105
Nothing contained in this act shall prohibit any parent, teacher, or other person from using ordinary
force as a means of discipline, including, but not limited to, spanking, switching, or paddling. A child is
not considered abused or neglected for the sole reason that the parent, in good faith, selects and
depends upon spiritual means alone through prayer, in accordance with the tenets and practice of a
recognized church or religious denomination, for the treatment or cure of disease or remedial care of
such child. Nothing contained in this paragraph shall prevent a court from immediately assuming
custody of a child and ordering whatever action may be necessary, including medical treatment, to
protect the child’s health or welfare. No medical treatment of a child with a disability shall be necessary
if, in the reasonable medical judgment of the attending physician, such treatment would be futile in
saving the life of the child.

12. 11. Daniel, B. (2015). Why have we made neglect so complicated? Taking a fresh look at
noticing and helping the neglected child. Child Abuse Review 24: 82-94. DOI:
10.1002/car.2296
"Developmental researchers tend to focus on the impact of unmet needs on children, thus
using a broad definition, whereas researchers on the operation of protective systems tend to
define neglect more narrowly as children labelled as such within formal systems."
"[Policies] focus very much on parental omission. Narrow definitions are often also applied to
ration (social, governmental) services."
"Neglect is highly associated with parental mental health problems, substance misuse, and
domestic abuse."
"confusion about whether the focus should be on: (1) the severity of the neglect and associated
harm to the child; or (2) the likelihood of the parents being able to accept help and make
changes without the need for compulsory measures."
"Recognizing and responding to neglected children is not a mechanistic activity; it requires
empathy with a child's plight."